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猩 红 热 Scarlet fever. 北京大学第三医院 崔蕴璞. Visiting the Doctor. Your subtitle goes here. Contents. 1. Etiology. 2. Epidemiology. 3. Clinical Manifestations. 3. Clinical Manifestations. 4 . Differential Diagnosis. Etiology. Group A hemolytic streptococcal pyogenes. GAS.

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visiting the doctor

猩 红 热

Scarlet fever

北京大学第三医院 崔蕴璞

Visiting the Doctor

Your subtitle goes here

slide2

Contents

1. Etiology

2. Epidemiology

3. Clinical Manifestations

3.Clinical Manifestations

4. DifferentialDiagnosis

etiology
Etiology

Group A hemolytic streptococcal pyogenes.

GAS

extracellular enzymes and toxins
Extracellular Enzymes and Toxins:

Streptococcal pyogenic exotoxins(SPE) 红疹毒素

Streptolysin O and S 溶血素

Streptokinase(SK) 链激酶

DNAases DNA酶

Hyaluronidase 透明质酸酶

Proteinase 蛋白酶

slide6

Contents

1. Etiology

2. Epidemiology

3. Clinical Manifestations

4. DifferentialDiagnosis

epidemiology1
Epidemiology

传染源:

  • 患者
  • 健康带菌者
epidemiology2
Epidemiology

传播途径:

  • 呼吸道飞沫
  • 食物、玩具间接经口
  • 皮肤伤口
epidemiology3
Epidemiology

易感人群:

  • 3~7岁儿童
epidemiology4
Epidemiology

流行季节:

Spring

Winter

slide12

Contents

1. Etiology

2. Epidemiology

3. Clinical Manifestations

3.Clinical Manifestations

4. DifferentialDiagnosis

slide13
分 期
  • Incubation period 潜伏期
  • Prodromal period 前驱期
  • Rash period 出疹期
  • Convalescent period 恢复期
incubation period
Incubation period

1~7days,mean 3days

No symptoms and signs

common type
Common Type
  • Incubation period
  • Prodromal period
  • Rash period
  • Convalescent period
prodromal period
Prodromal period

Fever

Headache

Abdominal pain

Swollen glands in the neck

Sore throat

White strawberry tongue

slide17

Prodromal period

Purulent tonsillitis

slide18

Prodromal period

White Strawberry tongue

Normal tongue

common type1
Common Type
  • Incubation period
  • Prodromal period
  • Rash period
  • Convalescent period
rash period
Rash period

Rash appears Whithin

24 ~48h after onset

of fever

Pastia’s lines

In 12~24h diffused

to the whole body

slide22

Modality of the rash

Sunburn with goose pimples

a difffuse,fine papular

slide23

Touch of the rash

fine sandpaper

slide25

Red Strawberry tongue

By the 3rd or 4th

day the white coat

peel off

common type2
Common Type
  • Incubation period
  • Prodromal period
  • Rash period
  • Convalescent period
slide27

Convalescent period

Rash begin to fade at

the end of the 1st week

Rash Vanish

in 2~4 days

slide28

Desquamation

at the end of the

1st week to the 2nd

week desquamation

occur

comes off as fine

flakes like bran

糠屑样脱皮

slide29

Desquamation

usually the last

to desquamate

not until the

2nd or 3rd week

characteristic manifestations
Characteristic Manifestations

Fever

Typical rash

Strawberry tongue

Pastia’s lines

Circumoral pallor

Desquamation

slide33

Contents

1. Etiology

2. Epidemiology

3. Clinical Manifestations

4. DifferentialDiagnosis

differential diagnosis2
Differential diagnosis
  • Varicella 水痘
slide37
Case
  • A seven year old boy presents with fever for one day, the temperature rises to 39.5 ℃,
  • He felt unwell flesh and fell, and complaining sore throat and headache,
  • Rash was detected in this morning
slide38
Case
  • PE: T 38.6℃, RR 32/min, HR 110 beats/min.
  • The mantal status is fine
  • The throat is red, and the tonsils are enlarged, reddened, and covered with patches of exudate.
  • The skin is covered with tiny red spots
  • No abnormal sign is found in lung, heart and abdomen.
summary
Summary

Scarler fever is an acute infectious disease

caused by group A hemolytic streptococcal pyogenes

Clinical features :Fever, Sore throat, Typical rash, Pastia’s lines, Circumoral pallor, Desquamation

STSS: invasive GAS, shock and multiple organ dysfunction

slide40

猩红热歌谣

两天出疹猩红热,

咽痛皮疹伴发热,

红布喷点深红色,

疹退皮脱还原色。

多饮水,早退热,

七天抗菌别吝啬。

多休息,床上卧,

预防肾炎风湿热。

slide41

THANK YOU

崔蕴璞email:jessypupu@sina.com.cn

Tele:13521024549